Advances and challenges in the treatment of primary central nervous system lymphoma

Primary central nervous system lymphoma (PCNSL), a rare variant of non-Hodgkin's lymphoma, is characterized by distinct biological characteristics and clinical behaviors, and patient prognosis is not satisfactory. The advent of high-dose (HD) methotrexate (HD-MTX) therapy has significantly improved PCNSL prognosis. Currently, HD-MTX-based chemotherapy regimens are recognized as first-line treatment. PCNSL is sensitive to radiotherapy, and whole-brain radiotherapy (WBRT) can consolidate response to chemotherapy; however, WBRT-associated delayed neurotoxicity leads to neurocognitive impairment, especially in elderly patients. Other effective approaches include rituximab, temozolomide, and autologous stem-cell transplantation (ASCT). In addition, new drugs against PCNSL such as those targeting the B-cell receptor signaling pathway, are undergoing clinical trials. However, optimal therapeutic approaches in PCNSL remain undefined. This review provides an overview of advances in surgical approaches, induction chemotherapy, radiotherapy, ASCT, salvage treatments, and novel therapeutic approaches in immunocompetent patients with PCNSL in the past 5 years. Additionally, therapeutic progress in elderly patients and in those with relapsed/refractory PCNSL is also summarized based on the outcomes of recent clinical studies.     

Combined treatment of rituximab,idarubicin, dexamethasone,cytarabine, methotrexate with radiotherapy for primary central nervous system lymphoma

The overall response rates and long‐term survival of primary central nervous system lymphoma (PCNSL) are still significantly inferior to the results achieved in similar subtypes of extranodal non‐Hodgkin's lymphoma. It is clearly necessary to investigate new therapeutic methods on PCNSL. We encountered three patients histologically documented PCNSL as diffuse large B‐cell lymphoma (DLBCL). They were treated with R‐IDARAM which comprised rituximab, idarubicin, dexamethasone, cytarabine and methotrexate. Patient 1 received stereotactic brachytherapy (SBT) prior to chemotherapy performed with iodine‐125 seeds (cumulative therapeutic dose 50 Gy). After six cycles of R‐IDARAM at 3‐weekly intervals, radiotherapy was applied at a dosage of 2000–4000 cGy in conventional schedule (180 or 200 cGy/day) to whole brain or spinal cord in all patients. Complete remission (CR) was achieved after first two cycles of R‐IDARAM in all patients. All three patients remained in CR at the time of this report with a median duration of follow‐up of 23 months (ranging from 13 to 41 months). Three patients have been alive for 41, 13, 16 months respectively until now. The patient with the longest survival time was the one given SBT prior to chemotherapy. This study suggests that R‐IDARAM combining with radiotherapy maybe a high effective regimen in PCNSL patients especially those with primary central nervous system DLBCL. A comprehensive treatment combining internal radiotherapy by SBT, modified R‐IDARAM and followed reduced external radiotherapy may be a new treatment concept for PCNSL with higher efficiency and lower toxicity.     

Erythropoietin processing in erythropoietic system and central nervous system

We describe possible functions of carbohydrates attached to growth factors and strategies to examine the functions, concentrating on erythropoietin, a major regulator of erythropoiesis. Erythropoietin in erythropoiesis functions as an endocrine hormone; it is produced by kidney cells and transferred into the circulation to hemopoietic sites. In the brain, erythropoietin acts on neurons in a paracrine fashion. Comparison of glycosylation has been made between kidney and brain erythropoietins.Abbreviations BHK Baby Hamster Kidney - Epo Erythropoietin - Epo-R erythropoietin receptor     

NMDA受体与中枢神经系统的发育

离子型谷氨酸受体分为NMDA型和非NMDA型两类,其中NMDA型受体与中枢神经系统发育关系密切。本文综述了NMDA受体的分子特性及NMDA受体五种亚单位NR1、NR2A、NR2B、NR2C和NR2D在动物出生后脑内的时空表达;NMDA受体亚单位在发育中的作用以及NMDA受体活性的胞内调节机制。     

Age-associated changes in central nervous system glycerolipid composition and metabolism

In this review, changes in brain lipid composition and metabolism due to aging are outlined. The most striking changes in cerebral cortex and cerebellum lipid composition involve an increase in acidic phospholipid synthesis. The most important changes with respect to fatty acyl composition involve a decreased content in polyunsaturated fatty acids (20:4n-6, 22:4n-6, 22:6n-3) and an increased content in monounsaturated fatty acids (18:1n-9 and 20:1n-9), mainly in ethanolamine and serineglycerophospholipids. Changes in the activity of the enzymes modifying the phospholipid headgroup occur during aging. Serine incorporation into phosphatidylserine through base-exchange reactions and phosphatidylcholine synthesis through phosphatidylethanolamine methylation increases in the aged brain. Phosphatidate phosphohydrolase and phospholipase D activities are also altered in the aged brain thus producing changes in the lipid second messengers diacylglycerol and phosphatidic acid.     

PPARβ在中枢神经系统中的作用研究进展

PPARβ是配体活化的核转录因子,属核受体超家族成员。PPARβ在哺乳动物体内表达十分丰富,日前对PPARβ的研究比较少,但现有的研究表明PPARβ可能参与了机体多种生理和病理过程。本文将对PPARβ的生物学特征及其在中枢神经系统中的意义作一综述。     

Leptin transport in the central nervous system

Synthesized and released by the adipose tissue, leptin is the widely studied 167‐amino acid hormonal protein product of the obesity gene. Originally leptin was defined in association with satiety and energy balance and claimed to be an anti‐obesity factor that functioned via a feedback effect from adipocytes to hypothalamus. There is a growing body of evidence that emphasizes the importance of leptin in the regulation of food intake and body weight in animals and humans, alike. Other research findings point out that it plays a role in the regulation of the metabolism, sexual development, reproduction, hematopoiesis, immunity, gastrointestinal functions, sympathetic activation, and angiogenesis. The aim of this review is to evaluate the relation between leptin and the central nervous system (CNS). Copyright © 2009 John Wiley & Sons, Ltd.     

Modulation by GABA of neuroplasticity in the central and peripheral nervous system

Apart from being a prominent (inhibitory) neurotransmitter that is widely distributed in the central and peripheral nervous system, -aminobutyric acid (GABA) has turned out to exert trophic actions. In this manner GABA may modulate the neuroplastic capacity of neurons and neuron-like cells under various conditions in situ and in vitro. In the superior cervical ganglion (SCG) of adult rat, GABA induces the formation of free postsynaptic-like densities on the dendrites of principal neurons and enables implanted foreign (cholinergic) nerves to establish functional synaptic contacts, even while preexisting connections of the preganglionic axons persist. Apart from postsynaptic effects, GABA inhibits acetylcholine release from preganglionic nerve terminals and changes, at least transiently, the neurochemical markers of cholinergic innervation (acetylcholinesterase and nicotinic receptors). In murine neuroblastoma cells in vitro, GABA induces electron microscopic changes, which are similar in principle to those seen in the SCG. Both neuroplastic effects of GABA, in situ and in vitro, could be mimicked by sodium bromide, a hyperpolarizing agent. In addition, evidence is available that GABA via A- and/or B-receptors may exert direct trophic actions. The regulation of both types of trophic actions (direct, receptor-mediated vs. indirect, bioelectric activity dependent) is discussed.Special issue dedicated to Dr. Claude Baxter.     

中枢神经系统去甲肾上腺素分泌的实时检测

为了探讨与中枢神经系统单胺类递质分泌失调有关疾病的中枢机制,人们对单胺类递质分泌动力学的研究越来越有兴趣。去甲肾上腺素是中枢神经系统重要的递质和调质,本文介绍了我们实验室最近发展的实时检测中枢神经系统去甲肾上腺素分泌的一些技术方法,并比较了电化学微碳纤电极（carbon fiber electrode,CFE）测量与电生理、荧光显微测量技术优缺点,阐述了CFE技术在神经科学研究中的一个基本应用。     

Specific RNase isoenzymes in the human central nervous system

After inactivation of RNase inhibitor by parachloromercuribenzoate, total alkaline RNase activity was found to be two fold higher in white matter as in grey matter extracts from human brain tissue. This activity was lower in human purified myelin. Two human cerebrospinal fluid (CSF) RNase isoenzymes of group 3 (a minor one, RNase 3.1, and a major one, RNase 3.2) were found to be present in human grey and white matter extracts and in purified myelin, but absent in human serum, peripheral nerve, liver, and spleen extracts. A RNase isoenzyme similar to central nervous system (CNS) RNase 3.2 was present in human kidney extracts but it differed in its carbohydrate structure. RNase isoenzymes 3.1 and 3.2 were not found in mouse, rat, and bovine brains. Thus, RNases 3.1 and 3.2 seem specific to human CNS. RNases of group 3 are the predominant RNase isoenzymes in CSF and one of the two predominant RNase groups in brain tissue. However, the proportion of RNases of group 3 is different in CSF and in brain extracts: RNases 3.1-3.2 are the major constituents of group 3 RNases in brain tissue, while another RNase isoenzyme of group 3, RNase 3.0, which is more glycosylated than RNases 3.1-3.2, is only a minor part of RNase of group 3 in brain extracts. Conversely, RNases 3.1-3.2 are lower or equivalent to RNase 3.0 in control CSF since the ratio of RNases 3.1-3.2 to RNase 3.0 did not exceed 1.0. This ratio decreased in pathological CSF including multiple sclerosis or infectious CNS diseases that were free of transudation phenomena. In conclusion, CSF RNases 3.1-3.2 seem to originate in brain tissue and could be markers of RNA catabolism from brain cells.     

New era of optogenetics: from the central to peripheral nervous system

Abstract

Optogenetics has recently gained recognition as a biological technique to control the activity of cells using light stimulation. Many studies have applied optogenetics to cell lines in the central nervous system because it has the potential to elucidate neural circuits, treat neurological diseases and promote nerve regeneration. There have been fewer studies on the application of optogenetics in the peripheral nervous system. This review introduces the basic principles and approaches of optogenetics and summarizes the physiology and mechanism of opsins and how the technology enables bidirectional control of unique cell lines with superior spatial and temporal accuracy. Further, this review explores and discusses the therapeutic potential for the development of optogenetics and its capacity to revolutionize treatment for refractory epilepsy, depression, pain, and other nervous system disorders, with a focus on neural regeneration, especially in the peripheral nervous system. Additionally, this review synthesizes the latest preclinical research on optogenetic stimulation, including studies on non-human primates, summarizes the challenges, and highlights future perspectives. The potential of optogenetic stimulation to optimize therapy for peripheral nerve injuries (PNIs) is also highlighted. Optogenetic technology has already generated exciting, preliminary evidence, supporting its role in applications to several neurological diseases, including PNIs.     

Chronic lymphocytic leukaemia presenting with central nervous system involvement

A 68-year-old man presented with hemiparesis, lymphocytosis, and cerebral lesions on MRI. Flow cytometry of blood, bone marrow and cerebrospinal fluid showed B-CLL lymphocytes with bright CD20 expression, slg, and absence of CD23 antigen. Fluorescencein situ hybridisation showed trisomy 12 in 50% of analysed peripheral mononuclear cells. The patient died 6 months after the diagnosis. Rapidly progressive and fatal course of the disease was consistent with known bad prognostic significance of CD20 bright expression and trisomy 12.     

先天性CMV感染致中枢神经系统畸形发育机制

胎儿中枢神经系统(central nervous system,CNS)是人类巨细胞病毒(human cytomegalovirus,HCMV)先天性感染的主要靶器官。胚胎期CMV感染常常导致严重CNS畸形的发生,其前提条件是CNS中的神经前体(干)细胞、神经元及神经胶质细胞对CMV普遍易感。发育期CNS感染CMV具有以下特点:⑴神经系统细胞对CMV的容纳性在CNS的不同发育阶段有所不同;⑵受累的细胞数随着发育的进展而增多;⑶CNS不同部位的细胞对CMV的敏感性存在明显的差异;⑷感染发生时细胞所处细胞周期的时相也与感染严重程度密切相关。CMV感染能诱导宿主细胞特异性的染色体折断,影响Homeobox基因(胚胎发育的主控基因)的表达,进而阻断细胞周期(G1期滞留)、诱导细胞凋亡,导致CNS细胞数量减少与迁徙异常,最终导致C N S发育畸形。     

SOCS家族在中枢神经系统的研究进展

细胞因子信号抑制因子（SOCS）家族是一类对细胞因子信号通路具有负反馈调节作用的蛋白分子,参与多种细胞因子、生长因子和激素的信号调节。细胞因子对中枢神经系统中的各种生物效应具有广泛多样的调节作用,SOCS家族的许多成员在发育时期和成年的脑内均有表达,SOCS家族不仅与细胞因子信号调节及中枢神经系统多种功能的调节密切相关,而且可能是神经发育和分化的重要调控因子,并参与神经免疫内分泌调节。本文综述了SOCS家族的发现、结构特点、脑内分布以及在中枢神经系统中的功能等方面的研究进展。     

Neuronal location of the bombesin-like immunoreactivity in the central nervous system of the rat

The immunohistochemical distribution of bombesin-like immunoreactivity in the central nervous system of the rat was revealed using a rabbit antibody against [Glu⁷]bombesin(6–14). In radioimmunoassay, the antibody had minimal cross reactivity with substance P thereby enhancing the significance of histochemical controls proving that the immunoreactivity detected was related to bombesin but not to substance P. Bombesin-immunoreactive neurons were detected in several brain structures including the hypothalamus, interpeduncular nucleus, central grey, dorsolateral tegmental nucleus, dorsal parabrachial nucleus, nucleus of the solitary tract and trigeminal complex. In the spinal cord, intense immunoreactivity was found in the superficial layers of the posterior horn. Since in this area the reaction diminished after rhizotomy the location of the peptide in afferent neurons was considered. In the anterior horn the bombesin-like immunoreactivity located in nerve terminal-like structures was unchanged after rhizotomy suggesting that the cell bodies were located in CNS.     

Melatonin,a calpain inhibitor in the central nervous system: Current status and future perspectives

Dysregulation of neuronal Ca²⁺ and oxidative stress plays an important role in the activation of cysteine proteases including calpains and caspases that contribute to neuronal death. In neurodegenerative diseases, traumatic brain injury, stroke, and neuropathic pain calpain activities are markedly increased. Melatonin is a beneficial supplement in the treatment of central nervous system (CNS) disorders. Melatonin is a potent antioxidant and works as a free-radical scavenger to regulate a large number of molecular pathways, including oxidative stress, inflammation, apoptosis, and cell death under different pathological conditions. However, limited studies have evaluated the inhibitory effect of melatonin on calpains. This review summarizes the current knowledge related to the effects of melatonin on calpains in some of the common CNS disorders.     

骨源活性物质的中枢调控功能

骨是机体的主要支持结构,也是参与机体运动和钙磷代谢的主要器官.骨也是一种潜在的新型内分泌器官,其通过骨细胞和骨髓分泌的多种生物活性物质,参与心血管、消化、内分泌等多个系统的生理和病理生理过程.骨源活性物质还可直接作用于中枢神经系统,参与脑功能和个体行为的调节,骨-脑轴的双向调控也逐渐引起了神经科学研究领域的关注.本文综...